Local
State
- Kids Chance of South Carolina
- South Carolina Association for Justice
- South Carolina Bar
- South Carolina Association for Justice
- State of South Carolina Government
- South Carolina Supreme Court
- S.C. Workers’ Compensation Education Association
- South Carolina Workers’ Compensation Commission
National
South Carolina Workers’ Compensation Forms
- Form #5 – Corporate Officer Notice to Reject
- Form #6 – Application to Create a Self-Insurance Fund – $250.oo
- Form #6A – Application for Membership in a Self-Insurance Fund – $25.00
- Form #7 – Application to Individually Self-Insure $250.00
- Form #7A – Corporate Guaranty
- Form #8 – SC Workers’ Compensation Commission Bond Required of Employer Carrying His Own Risk
- Form #8B – Irrevocable Letter of Credit
- Form #10 – South Carolina Self-Insurance Tax Form
- Form #11 – Fund Quarterly Financial Report
- Form #12A – First Report of Injury
- Form #12M – Annual Minor Medical Report
- Form #14B – Physician’s Statement
- Form #15 – Temporary Compensation Report
- Form #15S – Supplemental Report of Varying Temporary Partial Payments
- Form #16 – Agreement for Permanent Disability / Disfigurement Compensation
- Form #16A – Agreement for Permanent Disability / Disfigurement Compensation. Please complete this form for injuries occurring after July 1, 2007.
- Form #17 – Receipt of Compensation
- Form #18 – Periodic Report
- Form #19 – Status Report and Compensation Receipt
- Form #20 – Statement of Earning of Injured Employee
- Form #21 – Employer’s Request for Hearing
- Form #24 – Application for Lump Sum Award
- Form #27 – Subpoena
- Form #30 – Request for Commission Review
- Form #32 – Request to Waive Appeal Filing Fee
- Form #33 – Hearing Postponed
- Form #38 – Employer’s Withdrawal of Election to Adopt the South Carolina Workers’ Compensation Act
- Form #39 – Coverage Coding Sheet
- Form #50 – Employee’s Notice of Claim and or Request for Hearing
- Form #51 – Employer’s Answer to Request for Hearing
- Form #52 – Employee’s Notice of Claim and/or Request for Hearing
- Form #53 – Employer’s Answer to Request for Hearing, Death Case
- Form #54 – Employer’s Notice of Claim and/or Request for Hearing
- Form #55 – Second Injury Fund’s Answer to Employee’s Request for Hearing
- Form #58 – Pre-Hearing Brief
- Form #59 – Appellant’s Informal Brief
- Form #61 – Attorney Fee Petition
- Form #61 Order – Attorney Fee Petition
- Form #61A – Attorney Fee Petition Supplemental Information
- Form #65 – Occupational Disease Waiver
- Form #70 – Mediator Report
- Form #S-1 – Notice of Third Party Action Employee Carrier
- Form #S-2 – Notice of Third Party Action Employee
- Form #S-3 – Entitlement to Right of Action
- Form #S-4 – Court Certificate
Self-Insurance Forms
- Form #6 – Application to Create a Self-Insurance Fund
- Form #6A – Application for Membership in a Self-Insured Fund
- Form #7 – Application to Individually Self-Insure
- Form #7A – Corporate Guaranty
- Form #8 – SC Workers’ Com. Comm. Bond Required of Employer Carrying His On Risk
- Form #8B – Irrevocable Letter of Credit
- Form #10 – South CarolinaSelf-Insurance Tax Form (for calculations, Java scripting must be enabled in Adobe Reader)
- Form #11 – Fund Quarterly Financial Report
Claims Forms
- Form #12A – First Report of Injury
- Form #12M – Annual Minor Medical Report
- Form #14B – Physician’s Statement
- Form #15 – Temporary Compensation Report
- Form #15S – Supplemental Report of Varying Temporary Partial Payments
- Form #16 – Agreement for Permanent Disability/Disfigurement Compensation
- Form #16A – Agreement for Permanent Disability/Disfigurement Compensation. Please complete this form for injuries occurring after July 1, 2007
- Form #17 – Receipt of Compensation
- Form #18 – Periodic Report
- Form #19 – Saturation Report and Compensation Report
- Form #20 – Statement of Earnings of Injured Employee
- Form #24 – Application for Lump Sum Award
- Form #52 – Employee’s Notice of Claim and/or Request for Hearing
- Form #61 – Attorney Fee Petition
- Form #S-1 – Notice of Third Party Action Employee Carrier
- Form #S-2 – Notice of Third Party Action Employee
Judicial Forms
- Form #21 – Employer’s Request for Hearing
- Form #27 – Subpoena
- Form #30 – Request for Commission Review
- Form #32 – Request to Waive Appeal Filing Fee
- Form #33 – Hearing Postponed
- Form #51 – Employer’s Answer to Request for Hearing
- Form #53 – Employer’s Answer to Request for Hearing, Death, Case
- Form #54 – Employer’s Notice of Claim and/or Request for Hearing
- Form #55 – Second Injury Fund’s Answer to Employee’s Request for Hearing
- Form #58 – Pre-Hearing Brief
- Form #59 – Appellant’s Informational Brief
- Form #65 – Occupational Disease Waiver
- Form #70 – Mediator Report
